Wiki 41115 with 99238

[Deb2009]

If my Peds doc is doing a 41115 on a new born and then a d/c within the 10 day global, would a 79 modifier be appropriate on the 99238 when patient is discharged home?

 

[ajs]

If my Peds doc is doing a 41115 on a new born and then a d/c within the 10 day global, would a 79 modifier be appropriate on the 99238 when patient is discharged home?

Depends on what else is billed, is this a newborn that has never left the hospital? Usually for surgical procedures the discharge is included in the procedure, but if it was incidental to a different type of hospitalization then that may be different. In any case, the 79 modifier is not allowed with 99238, but a 25 or 24 modifier is allowed.

 

[Deb2009]

Depends on what else is billed, is this a newborn that has never left the hospital? Usually for surgical procedures the discharge is included in the procedure, but if it was incidental to a different type of hospitalization then that may be different. In any case, the 79 modifier is not allowed with 99238, but a 25 or 24 modifier is allowed.

Yes, this is a newborn that has not left the hospital. So the procedure would be inclusive of the discharge? Thank you. Your help is much appreciated. Peds is an area I am not familiar with.